Trends in Pancreatic Cancer Related Mortality in the United States from 1999-2020

Abstract

Background: Pancreatic cancer related mortality trends in the U.S. population have not been explored recently and the availability of the CDC WONDER database provides us the opportunity to do so. Objectives: The purpose of this study was to determine the directionality of trends and the regional differences in pancreatic cancer related mortality in the United States from 1999 to 2020. Methods: Death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research) database were inspected from 1999 to 2020 for pancreatic cancer related mortality in all age groups of the US population. Age adjusted mortality rates (AAMRs) per 100,000 persons and annual percentage change (APC) were calculated and compared with respect to year, sex, race/ethnicity and geographic region. Results: Between 1999 and 2020, 847589 Pancreatic cancer-related deaths occurred among all age groups of the U.S. population. The overall population AAMR increased from 11.2 in 1999 to 11.7 in 2020 (APC: 0.26; 95% CI: 0.20-0.32). Men had persistently higher AAMRs than women from 1999 (AAMR men: 12.9 vs women: 9.7) to 2020 (AAMR men: 13.6 vs women: 10.2). Non-Hispanic (NH) Black or African American population had the highest overall AAMR (14.5), followed by NH White (11.4), Hispanic or Latino (8.9), NH American Indian or Alaska Native (8.5), and NH Asian or Pacific Islander adults (8.0). AAMRs also varied by region (overall AAMR: Northeast: 11.9; Midwest 11.7; South: 11.3; West: 10.8). In comparing States, District of Columbia had the highest overall AAMR (14.0) and Utah the lowest (9.8). Comparison of 5-year age groups revealed the highest crude death rate in the 80-84 age group (93.5 per 100,000 persons), with an appreciable rise through the middle and older ages. We then analyzed data for adults between the ages of 45 and 84 and saw similar trends as before. Conclusion: Pancreatic Cancer- related mortality in U.S. has increased since 1999. Despite an overall decreasing trend of AAMRs from 1999 to 2020 for the NH Black or African American population, this category still had the highest AAMRs of the races/ethnicities. Men had persistently higher AAMRs than women. A disproportionate AAMR distribution pertaining to the States was exhibited. These differences warrant further investigation and focused approaches are needed to counter these mortality trends.